Multimodal Pain Management Protocol to Decrease Opioid Use and to Improve Pain Control After Thoracic Surgery

Area of Science:

• Pain Management
• Surgical Outcomes
• Public Health

Background:

• Opioid addiction is a major public health crisis, with many addictions originating from legally prescribed opioids.
• Up to 40% of patients develop opioid addiction after initial prescription for pain management post-injury or surgery.

Purpose of the Study:

• To evaluate the effectiveness of an opioid-free multimodal pain regimen in reducing opioid exposure.
• To assess if an opioid-free approach can maintain adequate pain control after minimally invasive lobectomy.

Main Methods:

• A retrospective study compared 313 patients undergoing minimally invasive lobectomy before and after implementing an opioid-free protocol.
• Data collected included preoperative characteristics, postoperative opioid use, pain scores, and discharge prescriptions.

Main Results:

• The opioid-free protocol group showed significantly lower average total morphine milligram equivalents at all measured time points.
• Patients on the opioid-free protocol experienced lower average pain scores and a higher percentage of time with pain scores below 3 and 6.
• Discharge without an opioid prescription increased from 7% to 62% with the opioid-free protocol.

Conclusions:

• Implementing an opioid-free protocol significantly decreased postoperative opioid use while effectively managing pain.
• The protocol reduced the number of patients discharged with opioid prescriptions, thereby decreasing a potential source of community opioid spread.